NPIMap

Organization Active NPI

Psychiatric and Counseling Associates LLC

Doing business as LifeStance Health

  • Behavioral Neurology & Neuropsychiatry Physician
  • Overland Park, KS
National Provider Identifier
1114096385
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X
Legal business name
PSYCHIATRIC AND COUNSELING ASSOCIATES LLC
Doing business as
LifeStance Health
Practice address
8400 W 110TH St.
Ste 100
Overland Park, KS 66210-2307
Phone
(913) 327-7505
Fax
(216) 456-8128
NPI assigned
Nov 6, 2006
Last updated
Oct 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ryan B Pardo
Title
Chief Legal Officer
Phone
(425) 279-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X Primary

Addresses

Primary practice location

8400 W 110TH St.
Ste 100
Overland Park, KS 66210-2307

Mailing address

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122-5694
Phone (253) 346-0392

Other names 1

  • LifeStance Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051011000074 KS Part B Supplier - Clinic/Group Practice 6507881422 Receives reassigned benefits from 51 practitioners
Practice locations: Lawrence, KS; Overland Park, KS; Wichita, KS
O20250723003753 MO Part B Supplier - Clinic/Group Practice 6507881422 Receives reassigned benefits from 3 practitioners
Practice locations: Kansas City, MO

National Provider Directory

National Provider Directory

Locations

11251 Nall Ave
Ste 100
Leawood, KS 66211
Phone (913) 327-7505

8400 W 110th St
Ste 100
Overland Park, KS 66210
Phone (913) 327-7505

8400 W 110th St
Ste 250
Overland Park, KS 66210
Phone (913) 327-7505

12541 Foster St
Ste 200
Overland Park, KS 66213
Phone (816) 942-7200

1855 N Webb Rd
Wichita, KS 67206
Phone (316) 634-0060

4100 N Mulberry Dr
Ste 102
Kansas City, MO 64116
Phone (816) 827-5110

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1114096385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25101 CHAGRIN BLVD",
            "address_2": "STE 100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225694",
            "telephone_number": "253-346-0392",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 W 110TH ST.",
            "address_2": "STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102307",
            "telephone_number": "913-327-7505",
            "fax_number": "216-456-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC AND COUNSELING ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "425-279-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeStance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.